In medicine and sports science, 'acute' denotes short-term or single-session effects, whereas 'non-acute' pertains to long-term, sustained training outcomes. Hypertensive patients need to exercise with caution, especially during isometric exercises, as such exercises may cause a sharp increase in blood pressure. However, long-term non-acute training may bring antihypertensive effects through mechanisms such as improving vascular function and reducing peripheral resistance, without causing acute risks. Therefore, long-term training may be safer than acute exercise. This article explores the cumulative effects of long-term training and quantifies the effects of long-term isometric contraction training on blood pressure (SBP, DBP) values in hypertensive patients, and provides evidence-based guidance for clinical doctors and rehabilitation therapists. This study was registered in the PROSPERO database, and qualified studies were identified through systematic searches in the following databases: PubMed, Web of Science, EMBASE, Cochrane Controlled Trial Center Registry, and EBSCO. The quality evaluation adopted the Cochrane Collaboration Network RCT bias assessment tool, using RevMan 5.4 software for data synthesis, forest plot creation, publication bias assessment, forest map creation, and publication bias assessment. This study has been registered at the National Institute for Health and Care Research (PROSPERO), ID: CRD42024602119. Five randomized controlled trials conducted in English were analyzed. The results showed modest changes in blood pressure relative to the control group: systolic blood pressure (SBP) decreased by an average of 2.31 mmHg (95% CI: -4.37 to 8.98), while diastolic blood pressure (DBP) saw a slight drop of 1.34 mmHg (95% CI: -6.31 to 3.44). As the confidence intervals include zero and show no statistical significance (p > 0.05), these reductions are not statistically significant but may suggest a potential effect worthy of further investigation. Although modest reductions in SBP and DBP were observed, the magnitude of change (mean SBP reduction: 2.31 mmHg) is below the clinically significant threshold of ≥ 5 mmHg recommended for hypertension management. Current evidence does not support isometric resistance training (IRT) as a standalone effective intervention. However, it may be considered a complementary approach within multimodal non-pharmacological strategies.
Yuan et al. (Thu,) studied this question.